Association of intravascular ultrasound- and optical coherence tomography-assessed coronary plaque morphology with periprocedural myocardial injury in patients with stable angina pectoris

Shigeki Kimura, Tomoyo Sugiyama, Keiichi Hishikari, Yosuke Yamakami, Yuichiro Sagawa, Keisuke Kojima, Hirofumi Ohtani, Hiroyuki Hikita, Atsushi Takahashi, Mitsuaki Isobe

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)

Abstract

Periprocedural myocardial injury (PMI) is not an uncommon complication and is related to adverse cardiac events after percutaneous coronary intervention (PCI). We investigated the predictors of PMI in patients with stable angina pectoris (SAP) on intravascular imaging. Methods and Results: We enrolled 193 SAP patients who underwent pre-PCI intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Clinical characteristics, lesion morphology, and long-term follow-up data were compared between patients with and without PMI, defined as post-PCI elevation of high-sensitivity cardiac troponin- T. PMI were observed in 79 patients (40.9%). Estimated glomerular filtration rate (odds ratio [OR], 0.973; 95% confidence interval [CI]: 0.950-0.996; P=0.020), ≥2 stents (OR, 3.100; 95% CI: 1.334-7.205; P=0.009), final myocardial blush grade 0-2 (OR, 4.077; 95% CI: 1.295-12.839; P=0.016), and IVUS-identified echo-attenuated plaque (EA; OR, 3.623; 95% CI: 1.700-7.721; P<0.001) and OCT-derived thin-cap fibroatheroma (OCT-TCFA; OR, 3.406; 95% CI: 1.307-8.872; P=0.012) were independent predictors of PMI on multivariate logistic regression analysis. A combination of EA and OCT-TCFA had an 82.4% positive predictive value for PMI. On Cox proportional hazards analysis, PMI was an independent predictor of adverse cardiac events during 1-year follow-up (hazard ratio, 2.984; 95% CI: 1.209-7.361; P=0.018). Conclusions: Plaque morphology assessment using pre-PCI IVUS and OCT may be useful for predicting PMI in SAP patients.

Original languageEnglish
Pages (from-to)1944-1953
Number of pages10
JournalCirculation Journal
Volume79
Issue number9
DOIs
Publication statusPublished - 25 Aug 2015
Externally publishedYes

Keywords

  • Angina
  • Biomarker
  • Intravascular ultrasound
  • Optical coherence tomography
  • Outcome

Fingerprint

Dive into the research topics of 'Association of intravascular ultrasound- and optical coherence tomography-assessed coronary plaque morphology with periprocedural myocardial injury in patients with stable angina pectoris'. Together they form a unique fingerprint.

Cite this